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The association of dementia on perioperative complications following primary total hip arthroplasty for femoral neck fractures

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

Studies evaluating the association of dementia in patients undergoing total hip arthroplasty (THA) for femoral neck fractures are limited. The aim was to investigate whether patients who have dementia undergoing THA for femoral neck fractures have higher rates of (1) in-hospital lengths of stay (LOS); 2) complications (medical and prostheses-related); and 3) healthcare expenditures.

Methods

A retrospective query using the PearlDiver database from January 1st, 2005 to March 31st, 2014 to identify patients with dementia undergoing primary total hip arthroplasty for the treatment of femoral neck fractures was performed. Dementia patients were 1:5 ratio matched to controls which yielded 22,758 patients in the study with (n = 3,798) and without (n = 18,960) dementia. Primary outcomes included comparing LOS, complications, and costs. A logistic regression was constructed to calculate the odds-ratios (OR) of dementia on complications. A p-value less than 0.004 was significant.

Results

Dementia patients had longer LOS (7-days vs. 6-days, p < 0.0001) and higher incidence and odds of medical complications (41.52 vs. 17.77%; OR 3.76, p < 0.0001), including cerebrovascular events (5.66 vs. 1.64%; OR 2.35, p < 0.0001), pneumoniae (9.98 vs. 3.82%; OR 1.82, p < 0.0001), and acute kidney injury (8.37 vs. 3.27%; OR 1.62, p < 0.0001). Study group patients had higher frequency of prostheses-related complications (9.53 vs. 8.31%; OR: 1.16, p = 0.012). The study group had greater total healthcare expenditures ($28,879.57 vs. $26,234.10, p < 0.0001) when analyzing ninety-day episode of care charges.

Conclusion

Patients with dementia undergoing THA due to femoral neck fracture have increased LOS, medical and prostheses-related complications, and cost of care compared to their counterparts.

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Authors and Affiliations

  1. Maimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY, 11219, USA

    Sukhpreet S. Ahluwalia, Javier Dejesus Lugo, Adam M. Gordon, Ivan J. Golub, Afshin E. Razi, Joseph Feliccia & Kevin K. Kang

  2. College of Medicine, State University of New York (SUNY) Downstate, Brooklyn, NY, USA

    Sukhpreet S. Ahluwalia & Javier Dejesus Lugo

Authors
  1. Sukhpreet S. Ahluwalia
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  2. Javier Dejesus Lugo
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  3. Adam M. Gordon
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  4. Ivan J. Golub
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  5. Afshin E. Razi
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  6. Joseph Feliccia
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  7. Kevin K. Kang
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Correspondence to Adam M. Gordon.

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The authors have no relevant financial or non-financial interests to disclose.

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The study was exempt from our institution’s Institutional Review Board (IRB) approval process.

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This was an observational study of publicly available, deidentified data. The Maimonides Medical Center Research Ethics Committee has confirmed that no ethical approval is required.

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Cite this article

Ahluwalia, S.S., Lugo, J.D., Gordon, A.M. et al. The association of dementia on perioperative complications following primary total hip arthroplasty for femoral neck fractures. Eur J Orthop Surg Traumatol 33, 971–976 (2023). https://doi.org/10.1007/s00590-022-03236-9

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  • DOI: https://doi.org/10.1007/s00590-022-03236-9

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